HHS Is Watching Out For Up-Coding From Providers During Crisis, Watchdog Promises
There's growing talking point among conservative-leaning media alleging that providers have a financial incentive to mark a death as COVID-19, but a top HHS official knocked down those claims. In other news on costs: surprising medical bills and struggling hospitals.
Modern Healthcare:
HHS Watchdog Monitoring Billing For Potential COVID-19 Upcoding
A top official at HHS' Office of Inspector General on Tuesday said the watchdog is monitoring billing and claims data to ensure hospitals are not upcoding to take advantage of higher COVID-19 reimbursement rates. "We are monitoring through our data accompanying bills and claims with a COVID diagnosis as a way to potentially upcode," Principal Deputy Inspector General for HHS Christi Grimm told members of the House Committee on Oversight and Reform. (Cohrs, 5/26)
Kaiser Health News:
COVID-Like Cough Sent Him To ER — Where He Got A $3,278 Bill
From late March into April, Timothy Regan had severe coughing fits several times a day that often left him out of breath. He had a periodic low-grade fever, too. Wondering if he had COVID-19, Regan called a nurse hotline run by Denver Health, a large public health system in his city. A nurse listened to him describe his symptoms and told him to immediately go to the hospital system’s urgent care facility. When he arrived at Denver Health — where the emergency room and urgent care facility sit side by side at its main location downtown — a nurse directed him to the ER after he noted chest pain as one of his symptoms. (Galewitz, 5/25)
Modern Healthcare:
Providence Losses Total $1.1 Billion In First Quarter
Renton, Wash.-based Providence health system reported a net loss of $1.1 billion in the first quarter of 2020, driven by an operating loss of $276 million and a non-operating loss of $837 million, according to financial filings. Higher operating expenses were behind most of the operating loss, while investment losses of $763 million led to the high non-operating losses, according to Providence. A year earlier, Providence reported net income of $543 million, an operating loss of $4 million and a non-operating gain of $547 million. (Barr, 5/25)
Modern Healthcare:
'No Path Forward' For Chicago Four-Hospital Merger
The merger of four financially struggling Chicago South Side hospitals is off. The move comes after lawmakers approved revisions to the state's hospital assessment program, but left out a pool of about $500 million to help facilities across the state transform in an evolving industry. The South Side hospitals were banking on a significant piece of the pot. (Goldberg, 5/26)
